MedicaidBilling CodesMedium impact
25-1112sum Summary Update: 3rd Quarter 2025 Injectable Medication HCPCS/DOFR Crosswalk
Health Net·CA·Pharmacy
Effective date
Jan 8, 2026
We identified it
Jun 20, 2026
Summary
Health Net and CalViva Health updated their Injectable Medication HCPCS/DOFR Crosswalk for Q3 2025, adding 18 new injectable medications, 9 biosimilars, 3 generic drugs, and making 45 updates to existing procedure codes. These changes affect how injectable medications are categorized for billing and reimbursement purposes.
Action Required
Before January 8, 2026: Billing team must download the complete update document (25-1112) from the Provider Library to review all 18 new injectable medications, 9 biosimilar updates, 3 new generic drugs, and 45 procedure code changes. Update billing system with new HCPCS codes and DOFR category assignments. Contact CalViva Health at 888-893-1569 with questions about specific code changes.